Which of the following is a second-generation antipsychotic?

Which of the following is a second-generation antipsychotic?

• A. Haloperidol
• B. Clozapine
• C. Loxapine
• D. Aripiprazole

Answer: (D)

Second-generation (atypical) antipsychotics are designed to treat psychosis with fewer movement-related side effects and sometimes better control of negative symptoms. Aripiprazole fits this group because it works differently from older drugs: it’s a D2 receptor partial agonist and also blocks 5-HT2A receptors. This combination helps stabilize dopamine signaling and tends to produce fewer extrapyramidal symptoms than classic D2 blockers, while still helping with psychotic symptoms. The serotonin interaction also contributes to mood and symptom benefits beyond dopamine blockade. Older, first-generation antipsychotics like haloperidol mainly block D2 receptors and are more likely to cause movement disorders such as EPS. Loxapine is typically classified as a traditional antipsychotic as well. Clozapine is another atypical antipsychotic, but the specific pharmacologic profile of aripiprazole—partial D2 agonism with 5-HT2A effects—is what places it in the second-generation category.

Second-generation (atypical) antipsychotics are designed to treat psychosis with fewer movement-related side effects and sometimes better control of negative symptoms. Aripiprazole fits this group because it works differently from older drugs: it’s a D2 receptor partial agonist and also blocks 5-HT2A receptors. This combination helps stabilize dopamine signaling and tends to produce fewer extrapyramidal symptoms than classic D2 blockers, while still helping with psychotic symptoms. The serotonin interaction also contributes to mood and symptom benefits beyond dopamine blockade.

Older, first-generation antipsychotics like haloperidol mainly block D2 receptors and are more likely to cause movement disorders such as EPS. Loxapine is typically classified as a traditional antipsychotic as well. Clozapine is another atypical antipsychotic, but the specific pharmacologic profile of aripiprazole—partial D2 agonism with 5-HT2A effects—is what places it in the second-generation category.